Synthetic bone graft in a contaminated open fracture?
For fracture repair in Bon Secours Mercy Health, OH, straight answers on graft timing and infection risk.
You have a grade II open tibia fracture with bone loss. You want to fill the gap, but infection worries you. Surgeons across Bon Secours Mercy Health ask the same thing. Place the synthetic graft now or wait for a second surgery? The answer depends on wound cleanliness.
A grade II open fracture means the skin broke and bacteria reached the bone. Bone loss leaves a void that must be filled for healing. Donor bone, or allograft, contains organic material. Bacteria can feed on that material. A synthetic graft like ACTIFUSE is inorganic. It gives bacteria nothing to eat. That makes infection less likely in a contaminated field. Many surgeons trust it for open fractures after a thorough washout. This is a key advantage.
Placing the graft at the first surgery adds little time. You mix the graft, pack the void, and close. If you stage it, the patient returns in 48 to 72 hours. The second procedure means another anesthesia, another operating room slot, and another hospital charge. Graft volume varies. A small distal radius defect may need 5 cc. A tibial plateau or calcaneus defect may need 20 cc or more. Cost depends on your facility contract and the amount used.
After debridement and pulse lavage, a synthetic graft can go in at the index surgery. It holds space and can be mixed with local antibiotics. If you see gross pus or dead tissue that cannot be removed, wait. Bring the patient back in 48 to 72 hours for a second look and graft placement. Do not pack a dirty wound and hope. Elite Surgical can walk your operating room team through the technique and product handling.
Once the graft is in and fixation is stable, the bone void is filled. New bone grows across the graft over weeks to months. Infection risk stays low because the graft is inorganic. You have a clear plan for follow-up. No second-guessing. The patient leaves with the defect addressed and the next step set.
Other things people in Bon Secours Mercy Health ask
bone graft for large tibial plateau defect
Pick a graft that resists compression and supports the articular surface. A moldable, high-porosity graft like ALTAPORE SHAPE packs into irregular voids and stays put. For smaller subchondral gaps, a flowable graft delivered by syringe gives complete fill without leaving dead space. Always use it with rigid internal fixation; the graft is not load-bearing on its own.
weight bearing after tibial plateau fracture with synthetic bone graft
Weight bearing depends on the fixation, not the graft. The graft provides a scaffold for bone ingrowth but does not add immediate structural support. Follow your standard postoperative protocol for the plate and screws. Most patients stay non-weight-bearing for 8 to 12 weeks, with progression based on X-ray healing. The graft will remodel over that time; early loading does not speed it up.
how to choose bone graft substitute for distal radius fracture
Match the graft form to the void shape. For a small, contained cavity, a flowable graft in a syringe (like ACTIFUSE FLOW) fills every corner without overpacking. For a larger, uncontained defect, a moldable graft (like ACTIFUSE SHAPE) holds its form and does not migrate. If you need antibiotic delivery, ACTIFUSE ABX gives you enhanced handling plus the option to mix in powdered antibiotics. Avoid granules that can scatter into the joint.
cost of bone graft substitute for calcaneus fracture
Calcaneus fractures often need 5cc to 10cc of graft. Price it by volume, not by level. Synthetic grafts like ACTIFUSE are priced per cc. Ask your rep for a per-case cost breakdown that includes the delivery system. Compare that to the cost of a second surgery if the void is left unfilled or collapses.
ACTIFUSE FLOW vs ACTIFUSE SHAPE fracture
For narrow, deep voids where you need the graft to flow into crevices, use ACTIFUSE FLOW. Its syringe delivery lets you place it precisely without overpacking. For a wide, shallow defect that needs to hold its shape while you close, ACTIFUSE SHAPE molds to the cavity and stays in place. If the void is both deep and wide, start with FLOW to fill the bottom, then cap it with SHAPE.
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Elite Surgical handles fracture repair in Bon Secours Mercy Health and the area around it.